Practical things to think about before you start radiotherapy

Before you start radiotherapy, your clinical oncologist or specialist radiographer will usually arrange an appointment to discuss your treatment and any possible risks or side effects with you.

You will be asked to sign a form giving your permission (consent) for the hospital staff to give you the treatment. Before signing, make sure you’ve seen and understand all the treatment information. Radiotherapy treatments can be difficult to understand, so it’s normal to have questions for the hospital staff.

Radiotherapy can harm a developing baby so you should avoid getting pregnant or fathering a child during treatment. If you think you may be pregnant, speak to your doctor or radiographer immediately. You should also let them know if you have:

a pacemaker

implantable cardiac device (ICD)

cochlear implant.

These devices can be affected by radiotherapy.

Radiotherapy may affect how much you can do at home and work. It may be an idea to arrange extra help and talk to your employer in advance, to help make it easier to cope.

Giving your consent

Before you have your planning scan or any treatment, your doctor will explain its aims. They will usually ask you to sign a form saying that you give permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you are asked to sign the form, you should be given full information about:

the type and extent of the treatment

its advantages and disadvantages

any significant risks or side effects

any other treatments that may be available.

If you don’t understand what you’ve been told, let the staff know straight away, so they can explain again. Some cancer treatments are complex, so it’s not unusual to need repeated explanations.

It’s a good idea to have a relative or friend with you when the treatment is explained, to help you remember the discussion. You may also find it useful to write a list of questions before your appointment.

People sometimes feel that hospital staff are too busy to answer their questions, but it’s important for you to know how the treatment is likely to affect you. The staff should be willing to make time for your questions.

You can always ask for more time if you feel that you can’t make a decision when your treatment is first explained to you.

You are also free to choose not to have the treatment. The staff can explain what may happen if you don’t have it. It’s essential to tell a doctor or the nurse in charge, so they can record your decision in your medical notes. You don’t have to give a reason for not wanting treatment, but it can help to let the staff know your concerns so they can give you the best advice.

Taking part in a trial

You may be asked to take part in a treatment research trial. There can be many benefits in doing this. Trials help to improve knowledge about cancer and develop new treatments. You will be carefully monitored during and after the study.

Usually, several hospitals around the country take part in these trials. It’s important to bear in mind that some treatments that look promising at first are often later found not to be as good as existing treatments or to have side effects that outweigh the benefits.

If you decide not to take part in a trial, your decision will be respected and you don’t have to give a reason. However, it can help to let the staff know your concerns so that they can give you the best advice. There will be no change in the way that you’re treated by the hospital staff, and you’ll be offered the standard treatment for your situation.

Pregnancy and fathering children

If you’re a woman of childbearing age, it’s important that you don’t become pregnant during your treatment. This is because radiotherapy given during pregnancy could harm a developing baby. Your doctors will be able to give you more information about this.

Before you give your consent for radiotherapy, you will need to confirm:

that you are not pregnant – you may need to provide a urine sample for a pregnancy test

that you understand you should avoid becoming pregnant during treatment, which means you’ll need to use a reliable form of birth control.

If you think that you may be pregnant at any time during your treatment, tell the doctors and radiographers immediately. Normally, they will offer you a pregnancy test.

If you’re a man having radiotherapy treatment, your doctors may advise you not to father a child during treatment and for a few months after it’s finished. You can ask your doctors for more information about this.

If you are having internal radiotherapy, your doctor or radiographer will give you further information about pregnancy and fathering children.

Pacemakers, implantable cardiac devices (ICDs) and cochlea implants

If you have a pacemaker, ICD or cochlea implant (a special implant in your ear), you must tell your oncologist or radiographer either before or during your first planning appointment. These devices can be affected by radiotherapy, so your treatment has to be planned to allow for them.

Help at home

Feeling tired is a common side effect of radiotherapy, so you may need help with day-to-day tasks. Although it can be hard to ask for help, family and friends are usually keen to do whatever they can. If you live alone or are caring for someone else, you can ask to see a hospital social worker about getting help.

Getting to your appointments and travel costs

You may want to drive yourself to hospital for your treatment. But remember, you may feel more tired as your treatment progresses. If you feel tired, it’s best to ask a relative or friend if they can drive you.

If you’re worried about getting to the hospital, let the staff in the radiotherapy department know. They may be able to arrange transport for you. Some local support groups and charities also provide transport.

If you have difficulty meeting the cost of travelling to and from the hospital every day, you may be able to get help with travel expenses. Some hospitals may offer reduced parking charges or provide you with a parking permit. They may also reimburse the cost of parking if you’re having daily radiotherapy treatment.

You may have a long journey to the hospital. Some hospitals offer hotel accommodation where you can stay overnight. However, you may have to pay for this.

Smoking

Research has shown that stopping smoking during and after radiotherapy may make it more effective. It can also reduce the side effects of treatment.

If you do smoke, you should try to cut down or stop. Many hospitals provide help or advice on how to quit smoking. Ask your clinical oncologist, radiographer, or specialist nurse if your hospital provides this service. If they don’t, your GP, a pharmacist or an organisation such as Smokefree will be able to help.

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